Search PubMed⌕ Search

Biomedical subjects

U Haller

Publications and source records attributed to U Haller.

At least 109 records · Page 6Linked to original sources
PubMed1995

[Effect of vaginal estrogen therapy on urinary incontinence in postmenopause].

A depot preparation of Estriol (Ortho Gynest D; 3.5 mg Estriol, intravaginal) was applied for 3 months to 135 postmenopausal women with urinary incontinence. Before and after treatment the symptoms of incontinence were scaled by the Gaudenz questionnaire. 8 symptoms were tested for statistical significance. All of them had significantly improved after treatment. 63% of patients showed improvement of their incontinence, urinary stress incontinence improved in 50%. Dysuria was reported by 14 patients before treatment, by none after treatment. Daytime and nighttime micturition frequency both decreased significantly, also subjective impairment by incontinence. Thus the local application of Estriol ovula represents an effective mode of primary treatment (maintenance therapy, one dose per week) in postmenopausal patients with urinary incontinence.

Administration, Intravaginal↗
PubMed1994

[Value of the lateral urethrocystogram in perineal ultrasound-- are there differences? A prospective study].

In the case of 81 patients, we conducted a perineal ultrasound and a lateral chain urethrocystography under standard conditions. The data collected were compared. The object of this prospective study was, to estimate the comparability of both methods. We also compared, whether the ultrasonically measured values were different between the supine and upright position. The measured values of both methods corresponded at rest, while during strain the values are different. During Valsalva's manoeuvre, the ultrasound method reflects the mobility of the bladder neck better, while the funnelling of the bladder neck can be examined better by lateral chain urethrocystography. The differences between the supine and upright positions were minor in the ultrasound examination, although the funnelling of the bladder neck could be detected better in the upright position. Our study shows that all important measured values can be collected with perineal ultrasound. Except for the funnelling of the bladder neck, typical findings of incontinence can be better shown with perineal ultrasound.

Adult↗
PubMed1994

[Quantitative determination of dose-response relations of taxol and cisplatin in ovarian cancer cells with a bioassay in comparison with cytomorphology].

The dose-response relations of the cytotoxic drugs taxol and cisplatin and their combination were analyzed in an ovarian cancer cell line (BG-1). The chemosensitivity profiles were obtained with 5 concentrations using the ATP cell viability assay (ATP-CVA). Furthermore, the cytomorphologic changes were analyzed. Our findings demonstrate that the ATP-CVA is able to determine the fraction of surviving cells and has proved to be an effective tool to measure cytotoxicity. At the same time we were able to analyze the cytomorphologic changes. The implications of these results for the practice of gynecologic oncology are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

[Determination of kidney function in patients with ovarian cancer treated with chemotherapy: calculation versus measurement of creatine clearance].

In patients with ovarian cancer receiving chemotherapy we compared the creatinine clearance measured in the usual way with the calculation of the creatinine clearance according to the formulas of Jelliffe and Cockroft. Regression analysis only showed a moderate correlation, whereas the analysis of the data by ROC curves allows the use of these formulas as screening tests with acceptable values of sensitivity and false-positive rate. Therefore, in the majority of these patients, collecting urine over 24 h before starting chemotherapy is no longer necessary.

Adult↗
PubMed1994

[Indications for ambulatory surgery].

Outpatient surgery demands a thorough evaluation of indication. It is of prime importance, influencing the entire problem of ambulatory operations. Although outpatient surgery is basically justified, the actual justification in any particular case is dependent upon the type and complexity of the operation as well as the anticipated postoperative situation. The decision to operate on an outpatient basis is an ongoing and dynamic process-it must take into consideration all the problems which might arise up to and even after discharge. An operation which is not specifically listed may still be performed on an outpatient basis if the individual circumstances justify this. The final decision will be determined by a number of factors, meaning that a strict list of indications is only of limited value.

Ambulatory Surgical Procedures↗
PubMed1993

[Surgical laparoscopy in tumors of the adnexa].

OBJECTIVES: The laparoscopic management of adnexal masses is still controversial. The main problems are preoperative diagnosis, operative technique and the possibility of compromising the prognosis by spillage of cancer cells when operating on a hitherto unrecognized early stage ovarian cancer. We report on our experience with minimal invasive surgery of adnexal masses. METHOD: From June 1989 to July 1992, 375 patients underwent surgery for adnexal tumors at the University Hospital, Zurich. In 112 cases a laparoscopic operation was performed. The indications were unilateral or bilateral masses in the adnexal region with or without clinical symptoms. The preoperative workup included patient's history, clinical examinations, vaginal sonography and intraoperative evaluation of the tumor. RESULTS: In 72% (83) of cases the organs were preserved by the laparoscopic procedure while in 28% (32) salpingo-oophorectomy, ovariectomy or salpingectomy was performed. The histopathologic findings included cystadenomas, cystadenofibromas, benign cystic teratomas, simple and functional cysts, mesothelium cysts, tubo-ovarian abscesses, endometriomas, and torqued tubes and/or ovaries. In no patient was a malignant process found. Only one postoperative complication was noted in a patient who had to be relaparoscoped due to adhesions to the operated ovary. One recurrence occurred in a hydrosalpinx. CONCLUSIONS: Adnexal masses may safely be managed laparoscopically, with all the advantages of minimal invasive surgery, provided that strict diagnostic and therapeutic rules are observed.

Adnexa Uteri↗
PubMed1993

[Minimally invasive surgery in the treatment of extrauterine pregnancy].

Of 147 patients operated by endoscopy, 86 (59%) were treated conservatively by linear salpingotomy or tubal aspiration and 61 (41%) were treated by salpingectomy. One patient with a history of bilateral salpingectomy had a cornual implantation and was also successfully treated by laparoscopic technique. There were no intraoperative complications. In eight patients (4.5%) with postoperative complications, a second operation was performed because of persistent trophoblast and/or hemorrhage. Six patients were treated by laparoscopic salpingectomy. All complications were associated with conservative treatment and typically occurred with a delay of up to 23 days. In six of these instances, the surgeon was rather inexperienced in laparoscopic operation. After an average follow-up time of 22 months, the pregnancy rate was 68%, of which 73% were intrauterine pregnancies. Laparoscopic treatment of ectopic pregnancies has proven to be an effective and safe procedure even at a teaching hospital. Since all complications occurred after conservative treatment this data suggests that salpingectomy should be the treatment of choice in ectopic pregnancy, whereas linear salpingotomy should only be performed when specially indicated.

Adolescent↗
PubMed1993

[Surgical strategy in incontinence and prolapse].

By means of 5 typical examples, repeated problems in the operative strategy of incontinence and descensus are discussed. Prior to each vaginal repair a urodynamic examination should be done to clarify the risk of incontinence. In the case of vaginal repair the periurethral structures should be preserved. In the case of abdominal colposuspension nonabsorbable suture material should be used. A wide elevation should be avoided. Continent patients with a cystocele and a urodynamically verified, hidden stress incontinence need, in addition, a vaginal colposuspension. In the case of vaginal stump prolapse the organ-saving operation (vaginal sacropexy) should be preferred to colpectomy. In the case of recurring stress incontinence, patients should preoperatively undergo an intensive local therapy, thus enabling a tension-free elevation.

Aged↗
PubMed1993

[Surgical gynecology today and tomorrow. Leading presentation of the 13th Academic Congress of German-Speaking University Faculty in Gynecology and Obstetrics, Hannover, 16th-19th May 1993: 1: Oncology and urologic gynecology].

It is shown how in gynaecologic oncology, proceeding from former standardized techniques, an individualized multimodal therapeutic concept has been developed. New aspects are introduced concerning diagnosis and treatment in the field of operative urogynaecology. The world-wide problem of performing poorly indicated hysterectomies is also addressed. Dynamic developments in the field of out-patient surgery will become an increasing challenge in the near future, influencing obstetrics and gynaecology to an extent that cannot at present be foreseen for the middle and long range. The forced evolution of conventional and laser-assisted laparoscopic surgery resulted in a nowadays broad spectrum of laparoscopically practicable surgical interventions, which made, even if still questioned by some experts, the vaginally assisted laparoscopic hysterectomy possible.

Combined Modality Therapy↗
PubMed1993

[Treatment of vulvar cancer].

125 patients with carcinoma of the vulva were evaluated with respect to corrected 5-year survival rates. In our study we try to answer two questions in the therapeutic management of vulval carcinoma: (1) Is organ-preserving surgery in stage I tumors adequate? (2) How important is the radiation therapy in the general treatment concept in more advanced stages of the disease? Our study shows that organ preservation seems to be possible in stage I disease, if resection of the tumor is complete with a margin of normal tissue. If inguinal lymph nodes are involved or the primary tumor is bulky, the best results are obtained with a combination of radical surgery and locoregional radiation therapy. Radiation therapy alone has a good effect during the early stage of the vulval cancer.

Aged↗